Comparison of Concurrent Use of Thoracic Radiation With Either Carboplatin-Paclitaxel or Cisplatin-Etoposide for Patients With Stage III Non–Small-Cell Lung Cancer

Steuer, Conor E.; Behera, Madhusmita; Ernani, Vinicius; Higgins, Kristin; Saba, Nabil F.; Shin, Dong M.; Pakkala, Suchita; Pillai, Rathi N.; Owonikoko, Taofeek K.; Curran, Walter J.; Belani, Chandra P.; Khuri, Fadlo R.; Ramalingam, Suresh S.

doi:10.1001/jamaoncol.2016.4280

Cited by 96 publications

(52 citation statements)

References 73 publications

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“…A systematic review and Veterans’ Health Administration data in the United States showed that carboplatin plus paclitaxel compared with etoposide plus cisplatin did not increase the risk of radiation pneumonitis in dCRT for stage III non–small-cell lung cancer. 26 , 27 However, retrospective studies have indicated that paclitaxel-based dCRT did significantly increase the risk of radiation pneumonitis, with an odds ratio of 3.33. 28 , 29 Liang et al 30 recently published a phase III trial that compared etoposide plus cisplatin with carboplatin plus paclitaxel in dCRT for patients with stage III non–small-cell lung cancer.…”

Section: Discussionmentioning

confidence: 99%

Comparing Paclitaxel Plus Fluorouracil Versus Cisplatin Plus Fluorouracil in Chemoradiotherapy for Locally Advanced Esophageal Squamous Cell Cancer: A Randomized, Multicenter, Phase III Clinical Trial

Chen

Zhu

et al. 2019

JCO

108

101

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PURPOSE This trial aimed to assess the efficacy and safety of the paclitaxel plus fluorouracil regimen versus the cisplatin plus fluorouracil regimen in definitive concurrent chemoradiotherapy (dCRT) in patients with locally advanced esophageal squamous cell carcinoma (ESCC). PATIENTS AND METHODS Patients with locally advanced ESCC were enrolled and randomly assigned to either the paclitaxel plus fluorouracil group or the cisplatin plus fluorouracil group. The patients in the paclitaxel plus fluorouracil group were treated with paclitaxel and fluorouracil one cycle per week in dCRT for five cycles followed by paclitaxel and fluorouracil one cycle per month in consolidation chemotherapy for two cycles. The patients in the cisplatin/5-fluorouracil group were treated with cisplatin and fluorouracil one cycle per month in dCRT for two cycles followed by two cycles in consolidation chemotherapy. The radiotherapy dose was 61.2 Gy delivered in 34 fractions. The primary end point was 3-year overall survival (OS). RESULTS Four hundred thirty-six patients with ESCC in six centers were recruited at a 1:1 ratio between April 2012 and July 2015. The median follow-up of the surviving patients was 48.7 months (interquartile range, 42.6-60.9). The 3-year OS was 55.4% in the paclitaxel plus fluorouracil group and 51.8% in the cisplatin plus fluorouracil group (hazard ratio, 0.905 [95% CI, 0.698 to 1.172]; P = .448). The 3-year progression-free survival was also not significantly different between the paclitaxel plus fluorouracil group and the cisplatin plus fluorouracil group (43.7% v 45.5%, respectively; hazard ratio, 0.973 [95% CI, 0.762 to 1.243]; P = .828). Compared with the cisplatin plus fluorouracil group, the paclitaxel plus fluorouracil group had significantly lower incidences of acute grade 3 or higher anemia, thrombocytopenia, anorexia, nausea, vomiting, and fatigue ( P < .05), but higher incidences of acute grade 3 or higher leukopenia, radiation dermatitis, and radiation pneumonitis ( P < .05). CONCLUSION The paclitaxel plus fluorouracil regimen did not significantly prolong the OS compared with the standard cisplatin plus fluorouracil regimen in dCRT in patients with locally advanced ESCC.

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Section: Discussionmentioning

confidence: 99%

Comparing Paclitaxel Plus Fluorouracil Versus Cisplatin Plus Fluorouracil in Chemoradiotherapy for Locally Advanced Esophageal Squamous Cell Cancer: A Randomized, Multicenter, Phase III Clinical Trial

Chen

Zhu

et al. 2019

JCO

108

101

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“…Lower dose parameters such as lung V5 have in some studies been correlated with higher risk of lung toxicity with either conventional RT or SBRT [95,96]. A systematic review showed that cisplatin or carboplatin-based chemotherapy can be used safely with concurrent chest radiotherapy [6,97]. Predictors of grade 5 pneumonitis were daily dose >2 Gy, V20 and lower-lobe tumour location.…”

Section: Dose-volume Constraints (Tables 2 and 3)mentioning

confidence: 99%

European Organization for Research and Treatment of Cancer (EORTC) recommendations for planning and delivery of high-dose, high precision radiotherapy for lung cancer

Ruysscher

Faivre-Finn

Moeller

et al. 2017

Radiotherapy and Oncology

174

119

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“…Only 4 patients were diagnosed as local recurrence confirmed by imaging and / or pathology and 3 of them died from the following causes: myelosuppression grade IV, sudden cardiac death, hemoptysis. The result showed that the ORR was kept at 90% by SIB-IMRT which was superior to the result of chemotherapy and conventional fractionated radiotherapy for local advanced NSCLC [26] . It may be due to the increase of ORR, the proportion of tumor shrinkage and regression increased ,which was beneficial to reduce the recurrence and mortality rate and positively correlated with the prolongation of survival rate [4] The OS and LPFS rates at 1, 3 and 5 years were 90%, 42.6%, 35.5% and 84.4%, 35.5%, 28.4%, respectively.…”

Section: Discussionmentioning

confidence: 90%

Simultaneous Integrated Boost of intensity modulated radiation therapy to Stage II-III Non-Small Cell Lung Cancer with metastatic lymph nodes

Liang

Ouyang

et al. 2020

Preprint

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Background: Local tumor failure remains a major problem after radiation-based nonsurgical treatment for unresectable locally advanced Non-Small Cell Lung Cancer （NSCLC）and inoperable stage II NSCLC .The aim of this study was to evaluate the feasibility of Simultaneous Integrated Boos of intensity modulated radiation therapy (SIB-IMRT) to Stage II-III NSCLC with metastatic lymph nodes. Methods: Patients were diagnosed by pathology or PET-CT. PTV was divide into two parts as follow, the PTV of primary tumor (PTVp) and the PTV of metastatic lymph nodes (PTVn) .The radiation doses were simultaneously prescripted 78Gy (BED = 101.48Gy) for PTVp and 60-65Gy (BED = 73.6-81.25Gy) for PTVn, 26f/ 5.2 weeks .Response was scored according to WHO criteria. Radiotherapy toxicity was scored according to RTOG criteria .Hematology and gastrointestinal toxicity were scored according to CTCAE1.0 criteria. Results: A total of 20 patients were enrolled. 17 patients were diagnosed by pathology and 3 patients were diagnosed by PET-CT . All patients were treated with SIB-IMRT. The objective response rate (ORR) was 90%, with CR 25%, PR 65%, NC 10% and PD 0%. Although Radiation toxicitiy was common, there were no grade≥3，with Radiation pneumonitis (10 cases), esophagitis (17 cases) and dermatitis (12 cases). The local control rates at 1, 3 and 5 years were 85%, 75% and 70%, respectively. The overall survival（OS）and local progression-free survival(LPFS) rates at 1, 3 and 5 years were 90%, 42.6%, 35.5% and 84.4%, 35.5% , 28.4%, respectively. The MST was 24 months. Conclusions: SIB-IMRT can significantly improve ORR and suivival for stage II-III NSCLC with metastatic lymph nodes , with high safety and satisfactory efficacy . Keywords: cancer/non-small-cell lung cancer; radiation therapy /SIB-IMRT; efficacy; safety Retrospective Trial Registration： (ChiCTR 2000029304)

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Comparison of Concurrent Use of Thoracic Radiation With Either Carboplatin-Paclitaxel or Cisplatin-Etoposide for Patients With Stage III Non–Small-Cell Lung Cancer

Abstract: Cisplatin-etoposide and carboplatin-paclitaxel regimens were associated with comparable efficacy when used with concurrent definitive radiotherapy for patients with stage III unresectable NSCLC. The toxic effect profiles favored the carboplatin-paclitaxel regimen.

Cited by 96 publications

References 73 publications

Comparing Paclitaxel Plus Fluorouracil Versus Cisplatin Plus Fluorouracil in Chemoradiotherapy for Locally Advanced Esophageal Squamous Cell Cancer: A Randomized, Multicenter, Phase III Clinical Trial

Comparing Paclitaxel Plus Fluorouracil Versus Cisplatin Plus Fluorouracil in Chemoradiotherapy for Locally Advanced Esophageal Squamous Cell Cancer: A Randomized, Multicenter, Phase III Clinical Trial

European Organization for Research and Treatment of Cancer (EORTC) recommendations for planning and delivery of high-dose, high precision radiotherapy for lung cancer

Simultaneous Integrated Boost of intensity modulated radiation therapy to Stage II-III Non-Small Cell Lung Cancer with metastatic lymph nodes

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